Saratoga Springs
December 1, 2010
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Kimberly E. Hoagwood, Columbia U
Serene Olin, NYSPI
Mary McHugh, OMH
Geraldine Burton, NYSPI
Nancy Craig, OMH
Anne Kuppinger, Families Together of NYS
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Project Director:
◦ Mary A. Cavaleri, NYSPI
Research Assistant: Jennifer Ball, NYSPI
Additional Collaborators:
◦ Jennifer P. Wisdom, NYSPI
◦ Naihua Duan, NYSPI
◦ Charles Glisson, U of TN
◦ Sue Marcus, NYSPI
◦ Mary M. McKay, Mt. Sinai School of Medicine
◦ *Funded by: National Institute of Mental Health
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Overview of study: Kimberly Hoagwood
OMH initiatives in family support: Mary
McHugh
Credentialing and training in family support:
Anne Kuppinger
Perspectives on the value of research
partnerships from family advocates: Nancy
Craig and Geraldine Burton
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Family-to-family (i.e., peer-delivered) services
in children’s mental health are gaining national
attention
◦ National Federation of Families credentialing project
◦ 137 chapters
◦ NAMI Basics curriculum: 12,000 parents have
participated in year 1
◦ ½ dozen states making it a billable service
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Important service model with little research data
to document its content and impact on families
and systems (Hoagwood et al., 2010 review)
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Reduces stigma and distrust by improving communication
(Linhorst & Eckert, 2003)
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Improves activation in seeking care (Alegria et al., 2008)
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Improves self-efficacy– i.e., active participation in decisionmaking (Heflinger & Bickman, 1997; Bickman et al., 1998)
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Improves knowledge and beliefs about children’s mental
health and this is associated with use of higher quality
services for children (Fristad et al., 2003; 2008)
Almost no rigorous studies thus jeopardizing long term
viability
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What is the content and structure of familyto-family services: components, staff
models, attitudes/beliefs of staff.
 Is it effective—Does it have a positive impact
on parents, youth, and on systems (e.g.,
costs, efficiencies).
 What are the best models for integrating
family peer advocates into service programs.
 How can family support services be used to
further the OMH goal of clinic restructuring
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OMH Perspectives: Reshaping
Policy—Mary McHugh, OMH
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From an emphasis on ‘family engagement’ to
‘family-driven services’.
A focus on developments in both the family
support movement and research regarding
the delivery of high quality, effective family
support services.
To guide these policies, the Division of
Children and Families includes Parent
Advisors who are intricately involved in our
planning and program operations.
Investing in Family Support
Services
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We invest over $14 million state and federal
dollars in the delivery of family support services.
We support Family-run and provider-operated
family support programs that deliver individual
and group peer support, referrals and linkages,
advocacy, skill development, care coordination,
respite, family recreation and basic supports.
We support strategies to improve partnerships
between mental health programs and family run
family support programs
Three Level Approach to Improving
Family Support in Mental Health
System
STATE POLICY
Definitions
Measurement
Financing
COMMUNITY
PROGRAMS
Expertise
Training
Shared Resources
PROVIDER ACTION
Redesign
Quality Improvement
Systems not Services
“You can’t expect an individual service provider
to transform their practice on their own; it is
much too expensive and complex. It is easier
to transform practices when they are part of a
system and achieve economies of scale”.
Ed Schor M.D., The Commonwealth Fund
FTNYS Perspective: Training/Credentialing
of Family Peer Advocates: Anne Kuppinger
Family Advocates Perspective:
Geraldine Burton
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What is research?
◦ The right question
◦ The right time
◦ Gathering of information
Who can do research?
Why is research important?
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Parents/caregivers
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Scientist
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Scholars
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Students
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Teachers
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Helps to inform, educate and enhance what we
already do.
What is it like to work in research as a
Family Advocate?
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Opportunity to work in collaboration and partnership
with the community and other researchers
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Opportunity to learn from each other
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Opportunity to share your experience
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Continue to work with families
Primary purposes of the study
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To examine the process and content of
services provided by family peer advocates
within 25 Waiver programs
To examine the social organizational context
within which family support is delivered
To understand how best to enhance the
quality of family support services
Examine the structure, process and content
of family support services
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25 waiver programs within 6 to 10 mental health
service agencies.
3 to 5 staff per waiver program (e.g., supervisors,
ICCs, family peer advocates, skill building staff,
others).
Participants
Measures
Time
point
Duration
Method of Data
Collection
Agency
Director
a. Interview
1 time
30 minutes
a. In person/phone
call
Waiver
Program Staff
a. Organizational
Social Context
questionnaire
*b. Walkthrough of
Services with
focus on Family
Support
c. Interviews with staff
about Family
Support Services
1 time
a. + c. = 1 hour
a. Staff meeting
b. In person
c. In person or
phone
interview
*2 hours
Standardized Parent Walkthrough
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Standardized Parent (SP) will participate in first
meeting with relevant Waiver staff
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SP will participate in a face-to-face appointment
with FPA
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At the end of the Walkthrough, the family peer
advocate will complete an interview
What will we do with the
information collected in Phase 1?
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Describe variations in process and content of
family support services across Waiver
programs
◦ Identify what family peer advocates do
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Describe how the social-organizational
context of Waiver programs relate to
indicators of service quality
Identify how agencies can support what
family peer advocates do
Examine organizational strategies to improve the
integration of family support within agencies
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Complete the application or contact us:
◦ Kimberly E. Hoagwood (Principal Investigator)
hoagwood@childpsych.columbia.edu
◦ Mary Cavaleri (Project Director)
cavaleri@pi.cpmc.columbia.edu
◦ Jennifer Ball (Research Assistant)
balljenn@childpsych.columbia.edu